Background: SHM Key Characteristic 9.1 on patient centered care encourages using guidelines/checklists to reinforce effective communication. Focused practice performance evaluations (FPPE) are a required regulatory hospital process for new medical staff members. In cognitive specialties, such as hospital medicine, completing an objective assessment of clinical skills can be difficult, with most initial evaluations based on [...]

Background: Uncertainty of viral transmission and PPE availability early in the SARS-CoV-2 pandemic created unique infection control challenges for hospitals. Prior to masking recommendations and widespread testing availability, the hospital medicine service at an academic hospital system published “medical distancing” guidelines to reduce the frequency and proximity of physician-patient interactions to minimize transmission. While previous [...]

Background: The American Academy of Pediatrics (AAP) publishes core pediatric clinical practice guidelines advising pediatricians on evidence-based management of common diagnoses. However, multiple studies demonstrate poor guideline compliance by pediatricians. There is no published curriculum on how to teach these guidelines, and on a national survey we conducted of pediatric residency training programs, only two [...]

Background: Initial management of acute upper gastrointestinal bleeding (UGIB) aims towards aggressive fluid resuscitation to maintain hemodynamic stability. Existing evidence regarding benefit of early endoscopy is unclear with some studies suggesting mortality benefits and some suggesting otherwise. The purpose of this study is to evaluate if there is any mortality benefit of doing early endoscopy [...]

Case Presentation: A 23-year-old man with cystic fibrosis presented to the Emergency Department with a two-day history of gradual, persistent, right sided abdominal pain associated with dark, tarry stools. He was afebrile with unremarkable vital signs. Exam was notable for generalized abdominal tenderness most noticeable in the right lower quadrant and a normal rectal exam. [...]

Background: Peripherally inserted central catheters (PICCs) are becoming increasingly popular due to their ease of insertion through upper extremity veins, although they are not complications-free. PICCs can be irritating and cause endothelial injury and inflammation resulting in venous thrombosis. Estimates suggest that more than a third of all deep venous thrombosis (DVT) in the upper [...]

Background: Epidemiology of Non-Variceal Upper Gastrointestinal Bleeding (NVUGIB) such as peptic ulcer bleeding, Mallory-Weiss tear, erosive gastritis/duodenitis, oesophagitis/oesophageal ulcer is well known among general population. However, data is lacking about its trend among Cirrhotic population in literature. No large database study is available to compare prevalence, predictors, and outcomes of NVUGIB among Cirrhotic patients. We [...]

Background: Copper is an essential trace element in the human body acting as a cofactor in many enzymatic reactions. Notably copper is involved in iron metabolism, neurohormone homeostasis, production of collagen, electron transport, regulation of gene expression, immune system function and melanin production. Two diseases that have been well documented in regards to copper regulation [...]

Background: The SARS-CoV-2 outbreak presents an infection control challenge to deliver care in a safe environment for patients and healthcare workers (HCW), further complicated by uncertainty regarding the nature of contagion of SARS-CoV-2 and PPE supply chain. On March 15, 2020, we introduced “medical distancing” rounding guidelines, with the aim of reducing transmission of COVID-19 when [...]

Background: During the COVID19 pandemic, the Centers for Medicare and Medicaid Services and US Department of Health and Human Services liberalized guidelines to allow for broader access to telehealth services. Previously the use of telehealth platforms in hospital and by the hospitalists has been limited. Purpose: Describe rapid implementation of an interprofessional, inpatient, secure telehealth [...]